Scabies increase during the COVID-19 pandemic: should we change our treatment strategy during the pandemic?

Scabies is a highly contagious, parasitic infestation caused by Sarcoptes scabiei var. hominis. There are some reports which claim the incidence of scabies has increased during COVID-19 lockdown. In this study, we aimed to compare the prevalence of scabies between March to September 2020 - the first six months of the COVID-19 outbreak in Turkey - and March to September 2019 - the same period in the previous year. Case number percentages were compared month-over-month and by total numbers for each specified period. Pearson's chi-squared test was the comparison tool used. We checked the records of 36,469 patients who were admitted to Bezmialem Vakif University, Faculty of Medicine, Dermatology Department, a tertiary healthcare center, between March and September 2019, and out of this number, 258 patients had been diagnosed with scabies. The overall scabies case percentage was 0.71% and the range of monthly prevalence was 0.57%-0.83%. During the corresponding period in 2020, 26,219 dermatology patients were admitted, and 465 of those patients were diagnosed with scabies. The overall scabies case percentage was 1.77% and the range of monthly prevalence was 1.37%-3.46%. Scabies prevalence percentages were statistically significantly higher in all months and in the overall total in 2020 (P<0.001). Our nine patients, who admitted in 2020, did not respond to permethrin treatment but responded well to an ivermectin and permethrin combination. Scabies incidence has increased during the COVID-19 pandemic according to our study. We believe there may be an underreported resistance to permethrin and that starting treatment with oral ivermectin in combination with topical permethrin in extraordinary times, such as a pandemic, may help to control outbreaks.

Which dermatology patients attend to Dermatology Outpatient Clinics during the SARS-CoV-2 outbreak in Turkey and what happened to them?

Coronavirus disease, first emerged in Wuhan, rapidly spread all over the world since December 2019. There are concerns about elective dermatology appointments and its results. Herein, we aimed to find out which type of dermatologic patients attended to dermatology outpatient clinic. The patients visiting the clinics for elective dermatologic diseases between March 11 and 18, 2020, were included in this study. Their age, sex, diagnosis of disease, requirement for emergent intervention, and their medical records about COVID-19 were obtained. There were 390 patients attending to the dermatology outpatient clinic in this period. The most common disease was acne (N: 94, 24%), only 19% of patients need emergent interventions or dose adjustment. There were 40 (10%) patients over the age of 65. After their visits, five patients were diagnosed as COVID-19 in 2weeks. Dermatologic examinations may be a vector for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission since being closed to the patient. Five of our patients were diagnosed as COVID-19 after their elective visit to hospital. Since the asymptomatic course of some young patients, most of our patients were not screened for COVID-19. Our findings support the concerns of elective physician examinations.